术前经动脉栓塞化疗治疗尾状叶肝细胞癌  

The role of preoperative TACE on hepatocellular carcinoma located in caudate lobe

作　　者：吴向嵩[1] 李茂岚[1] 吴文广[1] 谈竹君[1] 翁昊[1] 丁倩[1] 张林[1] 曹阳 杨佳华[1] 丁琦晨[1] 包润发[1] 束羿俊[1] 穆嘉盛[1] 陆建华[1] 董平[1] 顾钧[1] 刘颖斌[1] 彭淑牖[2] 

机构地区：[1]上海交通大学医学院附属新华医院普外科,200092 [2]浙江大学医学院附属第二医院普外科

出　　处：《中华外科杂志》2013年第9期780-783,共4页Chinese Journal of Surgery

摘　　要：目的评价术前经动脉栓塞化疗（TACE）对肝尾状叶肝细胞癌的疗效。方法回顾性分析2000年1月至2010年12月29例手术切除的肝尾状叶肝细胞癌患者，其中男性23例，女性6例，中位年龄52岁。根据是否接受术前TACE治疗分为联合组11例和手术组18例，比较2组患者的手术相关结果及5年生存率。结果联合组行TACE后，肿瘤最大径缩小超过33．3％者3例，缩小10．0％～33．3％者6例，缩小〈10．0％者2例。联合组平均手术时间（298±39）min，术中出血量（1031±310）ml；手术组平均手术时间（281±54）min，术中出血量（868±403）ml；组间差异无统计学意义（t=1．006，P=0．324；t=1．223，P=0．232）。联合组共发生并发症6例，死亡1例；手术组共发生并发症4例，无死亡病例；组间差异无统计学意义（x^2=0．028，P=0．868；x^2=0．633，P=0．426）。联合组5年生存率56．8％，手术组5年生存率34．9％，组问差异无统计学意义（P=0．132）。结论位于肝尾状叶的肝细胞癌，术前应用TACE不增加手术切除的难度和危险性，而且术前TACE具有改善患者长期生存的趋势。Objective To evaluate the effect of preoperative transarterial chemoembolization （TACE） on hepatocellular carcinoma located in caudate lobe. Methods Totally 29 cases of caudate lobe hepatocellular carcinoma admitted from January 2001 to December 2010 were analyzed retrospectively. Among the 29 patients, 23 were male and the other 6 were female. The median age was 52 years. According to receiving preoperative TACE or not, the 29 cases were divided into two groups： preoperative TACE plus surgery （group A, n = 11 ） and surgery only （group B, n = 18 ）. The surgical results and long-term survival were compared between two groups. Results After TACE, the diameter of the turnout reduced by over 33. 3% in 3 patients, 10. 0% to 33.3% in 6 patients, and less than 10. 0% in 2 patients. The duration of surgery and intraoperative blood loss in group A were （298 ±39 ） minutes and （1031 ±310） ml, respectively. The duration of surgery and intraoperative blood loss in group B were （281 ±54） minutes and （868 ±403 ） ml, respectively. No significant difference was found in terms of these two groups （t = 1. 006, P = 0. 324 ; t = 1. 223, P = 0. 232）. In addition, 6 cases in group A developed complications and 4 cases in group B did so. Only one patient died because of postoperative complication, and this patient belonged to group A. No significant difference was found between two groups （ X2 = 0. 028, P = 0. 868 ; X2 = 0. 633, P = 0. 426）. The 5-year survival rate was 56. 8% in group A and 34. 9% in group B. The difference did not reach significant difference （ P = 0. 132 ）. Conclusions For hepatocellular carcinoma located in candate lobe, preoperative TACE does not significantly increase the surgical difficulty and impair the safety. In addition, preoperative TACE has the tendency to provide benefit to long-term survival.

关 键 词：癌 肝细胞 药物疗法 肿瘤 局部灌注 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]